The Illness Model of Substance Abuse

Substance abuse as an illness remains a controversial topic in society. Some perceive substance abuse or dependence as a criminal activity or a character deficit and, moreover, believe that its treatment legitimizes or absolves abusers of responsibility for their actions. We strongly disagree with such views. 

A number of chronic conditions such as high blood pressure or diabetes bear certain similarities to snbstance use disorders. These illnesses prodnce a variety of physical symptoms that, if left untreated, can resnlt in significant medical complications and even death. Complications of uncontrolled diabetes inclnde blindness, kidney failure, neuropathies, and limb amputation. Similarly, inadeqnately controlled hypertension is a risk factor for stroke, heart attack, and other serions complications. Recognizing that these are diseases does not relieve the patient of responsibility indeed, the knowledge that one has snch an illness imposes significant responsibility. For example, knowing the likely ontcome of nncontrolled diabetes is hopefully an impetus for the diabetic to exercise, take medication, and 

Principles of Psychopharmacology for Mental Health Professionals By Jeffrey E. Kelsey, D. Jeffrey Newport, and Charles B. Nemeroff Copyright 2006 John Wiley Sons, Inc. 

Does applying the illness model to addiction provide a crutch for the addict In a word, no. When properly implemented, this model, in fact, readily explains the addict s vulnerability to abusing substances, predicts the course of illness should treatment either be sought out or not, and helps to guide rational therapy decisions that will increase the probability of keeping the illness in remission. 

One of the difficulties in discussing substance use disorders is that people from different disciplines use the terminology in a variety of ways, with the end result being considerable confusion. For this reason, we think it is important to review some of the more commonly used terms. 

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